Health and economic burden of obesity in Brazil

Ketevan Rtveladze, Tim Marsh, Laura Webber, Fanny Kilpi, David Levy, Wolney Conde, Klim McPherson, Martin Brown, Ketevan Rtveladze, Tim Marsh, Laura Webber, Fanny Kilpi, David Levy, Wolney Conde, Klim McPherson, Martin Brown

Abstract

Introduction: Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs.

Method: A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI).

Results: In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2)), but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000). 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000). The health care costs will double from 2010 ($5.8 billion) in 2050 alone ($10.1 billion). Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population.

Conclusion: Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.

Conflict of interest statement

Competing Interests: Authors KR, TM, LW, FK and MB are employed by Micro Health Simulations. GlaxoSmithKline provided funding for this study. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

References

    1. The World Health Organization (1995) Preventing Chronic Diseases: A Vital Investment. Geneva; vi–83.
    1. Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, et al. (2011) The global obesity pandemics: shaped by global drivers and local environments; The Lancet. 378: 804–814.
    1. The World Health Organization (2009) World Health organisation Statistics 2009. Geneva; 7–142; .
    1. Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, et al. (2011) Chronic non-communicable diseases in Brazil: burden and current changes. The Lancet 377: 1949–1961.
    1. Lotufo PA (2000) Increasing Obesity in Brazil: Prediction a New Peak of Cardiovascular Mortality. Sao Paulo Medical Journal 118: 161–162.
    1. The United Nations Department of Economic and Social Affairs; Population Devision (2002) World Population Aging: 1950–2050. New York; 1–37.
    1. Nooyens ACJ, Visscher TLS, Verschuren WMM Schuit AJ, Boshuizen HC, et al. (2008) Age, period and cohort effects of body mass weight and body mass index in adults: The Doetinchem Cohort Study. Public Health Nutrition 12: 862–870.
    1. Monteiro CA, Mondini L, de Souza AL, Popkin BM (1995) The nutrition transition in Brazil. European Journal of Clinical Nutrition 49: 105–113.
    1. Drewnowski A, Popkin BM (1997) The Nutrition Transition: New Trends in the Global Diet. Nutrition Reviews 55: 31–43.
    1. Popkin BM (1994) The Nutrition Transition in Low-Income Countries: An Emerging Crisis. Nutrition Reviews 52: 285–298.
    1. Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G (2010) Increasing obesity of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutrition 14: 5–13.
    1. Monteiro CA, Cannon G (2012) The Impact of Transitional “Big Food” Companies on the South: A View from Brazil. PLoS Medicine 9: 1–5.
    1. Monteiro CA (2010) The big issue is ultra-processing. Journal of the World Public Health Nutrition Association 6 .
    1. Levy RB, Claro RM, Mondini L, Sichieri R, Monteiro CA (2012) Regional and socioeconomic distribution of household food availability in Brazil, in 2008–2009. Revista Saude Publica 46: 1–9.
    1. Stuckler D, McKee M. Ebrahim Sh, Basu S (2012) Manufacturing Epidemics: The Role of Global Producers in increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol and Tobacco. PLoS Medicine 9: 1–8.
    1. Webb P, Block S (2010) Support for agriculture during economic transformation: Impacts on poverty and undernutrition. PNAS : 1–6.
    1. Monteiro CA, Benicio MH, Conde Wl, Popkin BM (2000) Shifting obesity trends in Brazil. European Journal of Clinical Nutrition 54: 342–346.
    1. Monterio CA, Conde WL, Popkin BM (2007) Income-Specific Trends in Obesity in Brazil: 1975–2003. American Journal of Public Health 97: 1808–1812.
    1. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M (2011) Health and economic burden of the projected obesity trends in the USA and the UK. The Lancet 378: 815–825.
    1. Webber L, Kipli F, Marsh T, Rtveladze K, Brown M, et al. (2012) High Rates of Obesity and Non-Communicable Diseases Predicted across Latin America. PLoS One 7: 1–6.
    1. Webber L, Kilpi F, Marsh T, Rtveladze K, McPherson K, et al. (2012) Modelling obesity trends and related diseases in Eastern Europe. Obesity Reviews 18: 744–751.
    1. Ministério da Saúde Brasil. VIGITEL Brasil 2006 (2007) Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico; Brasília; 1–302 .
    1. Barreto SM, de Figueiredo RC (2009) Chronic diseases, self-perceived health status and health risk behaviours: gender differences. Revista Saude Publica 32: 1–9.
    1. Moura EC, Malta D, Morais Neto OLD, Moteiro CA (2009) Prevalence and social distribution of risk factors for chronic noncommunicable diseases in Brazil. Revista Panamericana de Salud Publica 25: 17–22.
    1. The World Health Organization. Body mass index – BMI, [Accessed on 01/06/2011].
    1. Lobstein T, Leach RJ (2009) Data documentation for the Dynamic Modelling for Health Impact Assessment (DYNAMO-HIA) Project. Workpackage 7: Overweight and obesity report on data collection for overweight and obesity prevalence and related relative risks; I. 2009; 1–98.
    1. Rtveladze K, Marsh T, Barquera S, Sanchez Romero LM, Levy D, et al. (2013) Obesity Prevalence in Mexico; Impact on Health and Economic Burden. Public Health Nutrition 1: 1–7.
    1. The World Health Organization. Health statistics and health information; Software tools. [Accessed on 01/06/2011].
    1. Rtveladze K, Marsh T, Webber L, Kilpi F, Goryakin Ye, et al. (2012) Obesity Trends in Russia. The impact on health and healthcare costs. Health 2: 1471–1484.
    1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C et al. (2010) GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer. [Accessed on 01/06/2011].
    1. The World Health Organization; Global Health Observatory Data Repository. [Accessted December 2012].
    1. Sichieri R, do Nascimento S, Coutinho W (2007) The burden of hospitalization due to overweight and obesity in Brazil. Cadernos Saúde Pública 23: 1721–1727.
    1. Economist Intelligence Unit (2009) Breakaway: The global burden of cancer – challenges and opportunities. A report from the Economist Intelligence Unit; 1–72. .
    1. Barcelo A, Aedo C, Rajpathak S, Robles S (2003) The cost of diabetes in Latin America and the Caribbean; Bulletin of the World Health Organization. 81: 19–A.
    1. Dib MW, Riera R, F MB (2010) Estimated annual cost of arterial hypertension treatment in Brazil; Rev Panam Salud Publica. 27(2): 125–131.
    1. Bureau of Labor Statistics, United States Department of Labor; Inflation Calculator; [Accessed December 2012].
    1. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S et al.. (2007) Foresight Tackling Obesities: Future Choices - Project report. London: Government Office for Science; 1–161.
    1. Kopelman P, Jebb SA, Butland B (2007) Executive summary: Foresight: ‘Tackling Obesities: Future Choices’ project. Obesity Reviews 8: vi–ix.
    1. McPherson K, Marsh T, Brown M (2007) Tackling Obesities: Future choices - Modelling Future Trends in Obesity & the Impact on Health. London: Government Office for Science; 1–71.
    1. Fishman GS (1995) Monte Carlo: concepts, algorithms, and applications. Springer: New York, USA.
    1. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision, , [Accessed July 2011].
    1. National Diabetes Information Clearinghouse (NDIC); US Department of Health and Human Services; [Accessed December 2012].
    1. Rich-Edwards JW, Spiegelman D, Garland M, Hertzmark E, Hunter DJ, et al. (2002) Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology 13: 184–190.
    1. Macdiarmid J, Blundell J (1998) Assessing dietary intake: Who, what and why of under-reporting; Nutrition Research Reviews. 11: 231–253.
    1. Visscher TLS, Lucie A, Kroesbergen HT, Seidell JC (2006) Underreporting of BMI in Adults and Its Effect on Obesity Prevalence Estimations in the Period 1998 to 2001. Obesity 14: 2054–2063.
    1. Ford ES, Mokdad AH (2008) Epidemiology of Obesity in the Western Hemisphere; The Journal of Clinical Endocrinology & Metabolism. 93: s1–s8.
    1. Matsudo SM, Matsudo VR, Araujo TL, Andrade DR, Andrade El, et al. (2003) The Agita Sao Paulo Program as a model for using physical activity to promote health; Revista Panamericana de Salud Publica. 14: 265–272.
    1. Hawkes C (2007) Marketing Food to Children: Changes in the Global Regulatory Environment 2004–2006; The World Health Organization; 1–96.
    1. The OECD; Obesity and the Economics of Prevention: Fit not Fat – Mexico Key Facts; .
    1. Gortmaker SL, Swinburn BA, Carter R, Marby PL, Finegood DT, et al. (2011) Changing the future of obesity: science, policy and action; The Lancet. 378: 838–847.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit